title: An exploratory analysis of the correlation of pain scores, patient satisfaction with relief from pain, and a new measure of pain control on the total dose of opioids in pain care.
abstract: OBJECTIVE
  We explored the associations between opioid dose and multiple measures of pain.
  Thirty-two consecutive patients admitted solely for an acute exacerbation of cancer-related pain or for surgery were followed for their entire hospital stay (115 days of pain). For each hospital day, we collected pain scores, the number of pain scores, trends in pain scores, the percentage of time patients had 100% acceptable relief from pain, and the number of times patients were asked about acceptable pain relief. Finally, we asked those who had 100% relief of pain whether they could have used more pain medicine. Linear regression models were fit to estimate the amount of variation explained (R) in dose of medication, by each pain measurement variable.
  
  
  RESULTS
  Nineteen patients with cancer (74 days of pain) and 13 patients undergoing surgery (41 days of pain) were evaluated. Pain scores, the number of pain scores, trends in pain scores, and 100% acceptable relief scores poorly correlated with the use of medication in the linear regression models (R for all models ≤0.2). A question about needing more pain medicine explained the greatest amount of variation in opioid dose.
  
  
  CONCLUSIONS
  Pain and acceptable relief scores do not adequately reflect the use of medication. A prospective study is needed to further assess the value of additional measures of the adequacy of pain care.
authors.affiliation: Department of Medicine, Rush University Medical Center (Dr Harting, Abrams, Odwazny, Hasler, and McNutt), and Department of Health Systems Management, Rush University (Dr Johnson), Chicago, Illinois. This project was supported by grant number U19HS021093 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
authors.forename: Brian
authors.initials: B
authors.lastname: Harting
authors.forename: Tricia
authors.initials: T
authors.lastname: Johnson
authors.forename: Richard
authors.initials: R
authors.lastname: Abrams
authors.forename: Richard
authors.initials: R
authors.lastname: Odwazny
authors.forename: Scott
authors.initials: S
authors.lastname: Hasler
authors.forename: Robert
authors.initials: R
authors.lastname: McNutt
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009369:Neoplasms / Q000503:physiopathology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology; D017060:Patient Satisfaction
chemical_list: D000701:Analgesics, Opioid